Psychological Considerations in Revision Rhinoplasty

Abstract

Revision rhinoplasty is a unique challenge. In addition to the technical considerations that are inherently more difficult than those of primary cases, the surgeon must also be mindful of the psychological considerations that revision rhinoplasty presents. These patients are by definition unhappy with their prior rhinoplasty experience, and this perception of a suboptimal result is both legitimate and real, even if the surgeon is not in agreement. Tantamount to any intraoperative technique, the preoperative ability of the surgeon to sift through the myriad psychological and psychosocial issues is critical to achieving satisfactory outcomes for both patient and surgeon. Reasons for dissatisfaction with a primary surgery, reasons for seeking revision surgery, and the psychological profiles of revision rhinoplasty patients can differ from those related to other facial cosmetic procedures. This article attempts to provide the reader with a better understanding of the complex interplay of these issues and with this understanding help the reader to distinguish one who is a favorable surgical candidate from one who is best left unrevised.

Frequency of the Preoperative Flaws and Commonly Required Maneuvers to Correct Them

“…These common but negative perceptions naturally contribute to a surgeon's discomfort and reluctance in dealing with these patients. [6][7][8] A recent study by Constantian challenged the stereotype of the secondary rhinoplasty patient. He looked at the motivations, outcomes, and prevalence of unfavorable results in 150 secondary rhinoplasty patients and found that most secondary rhinoplasty patients have a legitimate source of displeasure, and satisfaction was often achieved once the deformity was corrected.…”

Body dysmophic factors and mental health in people seeking rhinoplastic surgery

“…Ambro et al reported these patients are unhappy with their prior rhinoplasty experience, and that the perception of a suboptimal result is both legitimate and real, even if the surgeon is not in agreement. Tantamount to any intraoperative technique, the preoperative ability of the surgeon to sift through the myriad of psychological and psychosocial issues is critical to achieving satisfactory outcomes for both the patient and surgeon 3 . In a previous study from our group, all patients undergoing rhinoplasty had a personality trait abnormality; the satisfaction rate of rhinoplasty was 55.1% 4 .…”

Psychological Considerations in the Revision Rhinoplasty Patient

“…Personality disorders are some of the most commonly encountered psychological disturbance in patients seeking cosmetic surgery. 11,12 This is especially true in men seeking rhinoplasty who demonstrate a propensity for dominant, manipulative, egocentric, and emotionally labile behavior. Often these male personality traits can be summarized with the pneumonic "SIMON": single, immature, male, overly expectant, and narcissistic.…”